Preliminary Exploration on the Value of Shear Wave Elastography in Evaluating the Effectiveness of Microwave Ablation on Hepatic Malignancies.

ABSTRACT: Shear wave elastography (SWE) is a new type of ultrasonic elastography that can quantitatively assess the elasticity and stiffness of tissues. This study aimed to investigate the value of SWE in evaluating the effectiveness of microwave ablation in hepatic malignancies. A total of 24 patients (including 30 lesions) with liver malignancies receiving microwave ablation treatment at the Cancer Hospital of Guangzhou Medical University from April 2018 to January 2019 were enrolled. The elastography was performed within 1 week before and after ablation. The SWE values in the central zone, the marginal zone of the lesion, and peripheral liver parenchyma were collected and analyzed. Before ablation, the mean of SWE value was 65.80 ± 13.37 kPa for the central zone of the tumor and 39.93 ± 7.87 kPa for the marginal zone, both of which were significantly greater than that for the perinatal liver parenchyma (12.85 ± 2.67 kPa, both P < 0.05). In the central and marginal zone of the lesions, the SWE value was significantly elevated after ablation (both P < 0.001) but not in the peripheral liver parenchyma (P = 0.444). Receiver operating characteristic curve analysis showed that the cutoff value for ablation in the marginal zone was 53.87 kPa, suggesting that an SWE exceeding 53.87 kPa is an index guaranteeing the ablation effectiveness. These results suggested that SWE has the potential to be used in evaluating the effectiveness of microwave ablation in liver cancers.

Evaluation of Microwave Ablation Efficacy by Strain Elastography and Shear Wave Elastography in ex Vivo Porcine Liver.

The aim of this study was to evaluate the efficacy of microwave ablation by ultrasound (US), strain elastography (SE) and shear-wave elastography (SWE). An ex vivo model of porcine liver was adopted. According to ablation power and duration, 30 samples were divided into three groups: group 1 (45 W, 30 s), group 2 (45 W, 15 s) and group 3 (30 W, 30 s). US was used to measure the largest transverse diameter (D1), vertical diameter (D2) and anteroposterior diameter (D3) of the ablated area. SE was used to measure the largest transverse diameter (SEL1), vertical diameter (SEL2) and anteroposterior diameter (SEL3). The actual size of the ablated area was measured as the largest transverse diameter (L1), vertical diameter (L2) and anteroposterior diameter (L3). SWE values and temperatures were measured in the central lesion (region a), marginal area (region b) and unablated area (region c). At 1 h post-ablation, the values measured by US (D1, D2, D3) were all significantly smaller than the ablated area (L1, L2, L3) in all three groups. Except for SEL2 in group 1, there was no significant difference in the results between SEL and L among the three groups. All SWE results were significantly higher post-ablation than pre-ablation in the central lesion (region a) and marginal area (region b, all p values <0.05). In regions a, b and c, the temperatures measured immediately and 5 min post-ablation were all higher than that measured pre-ablation. These results suggest that SE and SWE can be used to evaluate the ablation efficacy of liver tissue.

Comparative analysis of first-line treatment regimens for advanced EGFR-mutant non-small cell lung cancer patients with stable brain metastases.

BACKGROUND: To compare the survival outcomes of first-line treatment regimens for advanced epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) patients with stable brain metastases. METHODS: We conducted a systematic review of available data from randomized controlled trials (RCTs) of first-line treatment regimens of NSCLC patients with stable brain metastases. Progression free survival (PFS) and overall survival (OS) were extracted and analysed from the RCT subgroups. A network meta-analysis was constructed using the Bayesian statistical model to synthesize the survival outcomes of all the treatments. RESULTS: The analysis included 6 eligible RCT subgroups with 417 patients and 7 treatment regimens osimertinib, afatinib, first-generation EGFR-TKI (gefitinib or erlotinib), erlotinib + bevacizumab, gefitinib + pemetrexed + carboplatin, gemcitabine + cisplatin, and pemetrexed + cisplatin. Of these seven treatment regimens, gefitinib + pemetrexed + carboplatin had the highest potential for favorable PFS and OS, followed by osimertinib, in the treatment of advanced EGFR-mutant NSCLC patients with stable brain metastases. None of the results met the predetermined statistical significance of P<0.05. CONCLUSIONS: The regimens of "Gefitinib + pemetrexed + carboplatin" and "Osimertinib" were associated with the most favorable PFS and OS compared to the other therapies in advanced EGFR-mutant NSCLC patients with stable brain metastases, although the difference between these regimens and the others was not statistically significantly different.

Correlations between anterior wall motion velocity of ascending aorta measured by quantitative tissue velocity image and left ventricular geometry as well as left heart function in hypertension patients.

BACKGROUD: This study aimed to analyze the correlations between anterior wall motion velocity of ascending aorta measured by quantitative tissue velocity image (QTVI) technique and left ventricular geometry as well as left heart function to evaluate its value of clinical application. METHODS: One hundred ten hypertension patients and 35 healthy controls were included, divided into left ventricular concentric remodeling group and left ventricular hypertrophy group. The QTVI technique was used to obtain the velocity curve of anterior wall of ascending aorta, the peak systolic velocity (Vs), peak velocity of early diastolic motion (Ve) and peak velocity of late diastolic motion (Va). The single-plane Simpson method was utilized to measure the left ventricular ejection fraction (EF). The QTVI method was used to obtain the index of left ventricular diastolic function (Em/Am). RESULTS: Compared to control group, both Vs and Ve values significantly reduced in hypertension group (P<0.05). Both Vs and Ve values were significantly negatively correlated with LVMI and RWT (P<0.01). The Va value was negatively correlated with LVMI (P<0.05). The Vs value was significantly positively correlated with EF value (P<0.01). The Ve value was significantly positively correlated with both EF and Em/Am (P<0.01). The Va value was positive correlated with Em/Am (P<0.05). CONCLUSIONS: The QTVI anterior wall velocity of ascending aorta could be indicator for the geometric patterns and function of left ventricle, which may provide a simple and comprehensive method for clinical assessment of hypertensive heart disease.